instnjctions): During chronic opisthorchiasis, pathogenesis is manifested in a series of well-defined stages as the normal tissue architecture of the biliary epithelium is progressively remodeled by the chronic inflammatory response from repeated injury sustained by the biliary epithelium from a combinafion ofthe mechanical, toxic, and immune mechanisms of the fluke in the bile duct. As individuals are infected with O. viverrini for many years (often a lifetime), a persistent cycle of fissue damage and repair takes place in the intrahepafic biliary ducts, creafing a chronic inflammatory milieu that stimulates periductal fibrogenesis and provides the